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Poor Performance of National AIDS/STD Programme

Service to 1.69 lakh high-risk people uncertain
Service to some 1.69 lakh high-risk people for HIV/AIDS becomes uncertain as the World Bank (WB) warned the government of discontinuing the HIV/AIDS Targeted Interventions (HATI) project due to poor performance of National AIDS and STD Programme (NASP).
NASP failed to complete bidding procedure for six targeted interventions even after seven months, which was supposed to start from January 2009. So, the WB on June 16 warned the government of discontinuing the project if the process cannot .qe completed VyJunp 30. . ,
i “We don't want servide disruption as it will lead a huge number of high-risk group to a vulnerable condition and also would tend to increase the prevalence of AIDS/STD in the country,” said Dinesh Nayar, team leader of HNPSP (Health Nutrition and Population Sector Programme).
Under the HATI project, the injecting drug users (IDUs), brothel, street, hotel and residence-based sex workers and their clients and MSMs (males having sex with males) were provided services to control HIV/AIDS by around 200 NGOs. The time frame of service providing was fixed initially for 18 months from January 2009-June 2010 after completion of the 2nd phase of the project in December 2008.
But the dilly-dallying of the NASP to select NGOs to provide service to those high-risk groups lead 120,000 population to be deprived of getting services from April 2009 under three packages, including intervention for street-based sex workers, hotel and residence-based sex workers and internal migrant/client of sex workers as the activities are closed since April 2009.
The reason is that the NGOs that could not win the bidding process stopped working while the new NGOs,
which won the bidding, are yet to go through final agreement and cannot start their activities yet.
But the rest three packages, which include interventions of brothel-based sex workers, IDUs and MSMs that continued their activities till June, might be stopped now, raising the toll of vulnerable people to 1,69,000 as fresh bidding is yet to be completed.
Without showing any apposite reason, NASP retendered for these three packages cancelling prior proposal from interested NGOs and bidders again submitted the proposal to NASP.
But if the government fails to choose the NGOs properly, within a very short time and if» the WB does not continue the project, the future of approximately 169,000 target population will be uncertain, said the activists working with the vulnerable groups, adding that many of the Drop in Centres (DICs) have been closed by this time from where the high-risk groups used to receive services.
Talking to The Daily Star, Programme Manager of NASP Abdur Rahman, however, said WB would not create any problem as in a meeting on June 25, the government and the WB reached an under-
standing that the bidding would be completed within a very short time soon after revising the operational plan.
He further said that service is not interrupted anywhere.
But the fact is that Care Bangladesh has already stopped its activities under the HATI project.
"The 32 DICs which were run by the Care directly to provide services to the IDUs have been closed from June 30," said Selina Ferdous, team leader of Care Bangladesh, adding that they sent a letter to the government regarding this in 1st week of June and as the government neither responded to the letter nor signed, any agreement with -them, they stepped providing services.
“HIV prevalence would increase if the beneficiaries are deprived of getting services," said Prof Nazrul Islam of Virology department at BSMMU, adding that very few people were brought under the coverage and if they are dejected in this way, it will be harmful for society.
The achievements of last five years would be wiped out if the programme is halted even for few days, according to experts.
The NGOs continuing their activities under HATI project
also apprehended that taking the chance of weaknesses of HATI, Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) is capturing the targeted interventions. For this reason, those who would win the bidding process won’t have any place to work for.
However, Save the Children USA, which is managing the fund and technical side of GFATM fund, said it has been working with 45 NGOs and as per the government decision, it is working with a small group of IDUs at a specific point at old Dhaka in the city where the prevalence of HIV/AIDS is highest amopg thelDUs.
“We aiQ working, here just for an interim period," said Deputy Director in Programme Implementation and Management Amjad Ali.
Considering AIDS a national priority issue, the government established NASP as a separate wing under the health and family welfare ministry. But negligence of the high officials of NASP tends to turn the programme a vulnerable one.
In the last six months, two programme managers and two line directors were changed in the NASP leading to stop the programme.